Impact of previous surgery on time taken for incision and division of adhesions during laparotomy

Coleman, Mark; McLain, Alexander D; Moran, Brendan

doi:10.1007/bf02237441

Cited by 215 publications

(141 citation statements)

References 4 publications

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“…Adhesions can cause long-term morbidity, including infertility, bowel obstruction, and possibly pelvic pain (9)(10)(11)(12)(13). Subsequent surgeries are also likely to be prolonged and potentially incur greater risks, such as bowel injury (14). Despite their overbearing influence on surgical care, the mechanisms by which injury to the peritoneum triggers the inflammatory response leading to postoperative adhesion development remains poorly understood.…”

mentioning

confidence: 99%

Nitric oxide synthase isoforms expression in fibroblasts isolated from human normal peritoneum and adhesion tissues

Jiang

Zhu

Diamond

et al. 2008

Fertility and Sterility

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Objective-To determine the expression of nitric oxide synthases (NOSs) and their modulation by hypoxia in human peritoneal (NF) and adhesion fibroblasts (ADF). Design-Prospective experimental study.Setting-University medical center. Patient(s)-Fibroblasts from peritoneum and adhesion tissues. Intervention(s)-Hypoxia and silencing inducible NOS (iNOS) gene expression in fibroblasts.Main Outcome Measure(s)-We used reverse-transcriptase polymerase chain reaction to quantify messenger RNA (mRNA) levels of NOS isoforms. Griess assay was used to measure NO levels. Result(s)-The mRNA copies/μg RNA of neuronal NOS (nNOS) and endothelial NOS (eNOS) were 6.6 × 10 3 in NF, 5.7 × 10 3 in ADF and 7.0 × 10 3 in NF, 6.1 × 10 3 in ADF, respectively. The mRNA copies/μg RNA of iNOS were 31.3 × 10 3 in NF and 33.0 × 10 3 in ADF. Hypoxia increased iNOS mRNA copies/μg RNA from 31.3 × 10 3 to 61.3 × 10 3 in NF and from 33.0 × 10 3 to 63.9 × 10 3 in ADF, whereas there were no changes in mRNA levels of nNOS and eNOS in NF and ADF. Nitric oxide levels were lower in ADF (0.94 μmol/L) than NF (1.97 μmol/L). Silencing iNOS decreased NO levels in NF (from 1.97 μmol/L to 0.41 μmol/L) and in ADF (from 0.94 μmol/L to 0.27 μmol/L). Conclusion(s)-Nitric

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mentioning

confidence: 99%

Nitric oxide synthase isoforms expression in fibroblasts isolated from human normal peritoneum and adhesion tissues

Jiang

Zhu

Diamond

et al. 2008

Fertility and Sterility

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“…Further, it is known that in reoperations, there is increased risk of bleeding and injury of adjacent organs (20). The secondary problems of intraabdominal adhesions formed after laparotomy may cause to economical costs (17,18). This study determined that the control group irrigated with SF showed more significant adhesion scores than the ID and HA groups.…”

Section: Discussionmentioning

confidence: 81%

“…Some of these problems may entail re-operation. It was indicated that abdominal adhesions formed after secondary laparotomy extended the laparoscopy, complicated the exploration and increased the possibility of iatrogenic intestinal diseases (17,18). It was reported that, in general surgery, 1% of all attempts and 3% of laparotomies are caused by peritoneal adhesions (19).…”

Section: Discussionmentioning

confidence: 99%

Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions

Baskonus¹,

Maralcan²,

Gökalp³

et al. 2013

Gaziantep Med J

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This experimental study was designed to compare the effects and costs of 4% icodextrin and hyaluronic acid in intraabdominal adhesion formation in rats. This study included 30 healthy Wistar albino rats, each weighing 250-300 gr. Following cecal-ileal abrasion to rats in each group, the following treatments were applied: Group 1 (control, n:10) 5 ml saline irrigation; Group 2 (n:10) 5 ml 4% icodextrin solution; Group 3 (n:10) 3 ml auto-crosslinked hyaluronic acid gel. After 14 days, following a second operation, adhesion intensity scoring, histopathological assessment (inflammation, fibrosis) and costs were compared between groups. The lowest postoperative adhesion intensity score was found in the group 3 and the highest score was found in the group 1 (p=0.028). Group 3 had a non-significantly lower adhesion intensity score than group 2 (p>0.05). In terms of inflammation and fibrosis, group 2 had the lowest score, but there were no significant differences between all the groups (p>0.05). In terms of cost, 4% icodextrin is less expensive than hyaluronic acid. The results demonstrated that both hyaluronic acid and 4% icodextrin are similarly effective in reducing postoperative intraabdominal adhesions. In addition, 4% icodextrin is more cost-effective, which can be an advantage for clinical studies.

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“…This is especially evident in patients with a history of previous abdominal surgery [10], while other causes of adhesion account for few cases [11]. The presence of adhesions adds a mean 24 min to the surgical duration, increases the risk of iatrogenic intestinal injury, and makes future laparoscopic surgery more difficult or even impossible [12,13]. Therefore, emergency surgery is mandatory only in cases of strangulation or complete obstruction to avoid generating new adhesions needlessly [14].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Plain and Contrast Radiography, and Multi-slice Computed Tomography in Diagnosing Intestinal Obstruction in Different Locations

Liu

Sun

2015

Indian J Surg

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Early intestinal obstruction is easily misdiagnosed. Many physicians consider terminal bouton if computed tomography (CT) scan is done. However, different examinations provide diverse information and significance. This retrospective, randomized, clinical study investigated the diagnostic value of three imaging modalities for intestinal obstruction, supine and upright (or decubitus) plain abdominal radiography, contrast radiography using Gastrografin, and 64 multi-slice spiral CT (MSCT). A total 142 patients with intestinal obstruction were examined. The diagnostic accuracy of plain radiography, contrast radiography, and MSCT for detecting small bowel obstruction was 62.5, 85, and 77.5 %, for localizing the obstruction was 0, 90, and 78.75 %, and for determining the cause of obstruction was 0, 71, and 65 %, respectively. The diagnostic accuracy for detecting large bowel obstruction was 53.23, 73.17, and 92 %, and for localizing the obstruction was 38.17, 60.98, and 98 %, respectively. The diagnostic accuracy of MSCT in determining the cause of obstruction was 91 %. None of the patients administered Gastrografin experienced any adverse effects. In conclusion, MSCT has great diagnostic value in identifying the site and cause of intestinal obstruction, especially in cases of large bowel obstruction. Contrast radiography using Gastrografin was effective in diagnosing and treating small bowel obstruction, making it a beneficial adjunct to MSCT.

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Impact of previous surgery on time taken for incision and division of adhesions during laparotomy

Cited by 215 publications

References 4 publications

Nitric oxide synthase isoforms expression in fibroblasts isolated from human normal peritoneum and adhesion tissues

Nitric oxide synthase isoforms expression in fibroblasts isolated from human normal peritoneum and adhesion tissues

Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions

Diagnostic Value of Plain and Contrast Radiography, and Multi-slice Computed Tomography in Diagnosing Intestinal Obstruction in Different Locations

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